Coxsackie A

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colspan=2 style="text-align: center; background-color: rgb(250,250,190)" | Coxsackie A virus
Electron micrograph of Coxsackie A virus
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Species	Enterovirus A

Coxsackie A virus is a member of the Enterovirus genus of the Picornaviridae family. It is a non-enveloped, positive-sense single-stranded RNA virus. Coxsackie A viruses are known to cause a variety of diseases, most notably hand, foot, and mouth disease (HFMD) and herpangina.

Virology

Coxsackie A viruses are small, icosahedral viruses with a diameter of approximately 27-30 nm. They possess a single-stranded RNA genome of about 7.5 kb in length. The genome encodes a single polyprotein that is cleaved into structural and non-structural proteins. The structural proteins form the viral capsid, which is composed of four proteins: VP1, VP2, VP3, and VP4.

The virus is transmitted primarily via the fecal-oral route, but can also spread through respiratory droplets and contact with contaminated surfaces. After entering the host, the virus replicates in the oropharynx and intestinal tract before spreading to other tissues.

Clinical Manifestations

Coxsackie A viruses are associated with several clinical syndromes:

• Hand, foot, and mouth disease (HFMD): This is the most common disease caused by Coxsackie A viruses, particularly Coxsackie A16 and Enterovirus 71. It is characterized by fever, sore throat, and a rash with vesicles on the hands, feet, and mouth.

• Herpangina: This condition is characterized by sudden onset of fever, sore throat, and vesicular lesions on the soft palate and uvula. It is most commonly caused by Coxsackie A viruses, especially Coxsackie A1 to A6, A8, A10, and A22.

• Acute hemorrhagic conjunctivitis: Coxsackie A24 is one of the viruses that can cause this highly contagious eye infection, characterized by sudden onset of eye pain, redness, and subconjunctival hemorrhage.

Diagnosis

Diagnosis of Coxsackie A virus infections is primarily clinical, based on the characteristic symptoms and epidemiological context. Laboratory confirmation can be achieved through:

• Viral culture: Isolation of the virus from throat swabs, stool samples, or vesicular fluid.
• PCR (Polymerase Chain Reaction): Detection of viral RNA in clinical specimens.
• Serology: Detection of specific antibodies against Coxsackie A viruses, although this is less commonly used.

Treatment and Prevention

There is no specific antiviral treatment for Coxsackie A virus infections. Management is primarily supportive, focusing on relieving symptoms such as fever and pain. Good hygiene practices, such as regular handwashing and disinfection of contaminated surfaces, are crucial in preventing the spread of the virus.

Epidemiology

Coxsackie A viruses are distributed worldwide and infections occur predominantly in children, especially those under 5 years of age. Outbreaks of HFMD and herpangina are common in childcare settings and schools.

Also see

• Enterovirus
• Picornaviridae
• Hand, foot, and mouth disease
• Herpangina
• Acute hemorrhagic conjunctivitis